Premasseter space: anatomy of the lateral cheek
- Nerve
- Highlighted area
Quick facts
- Location
- Over the lower part of the masseter muscle, above the edge of the mandible, on each side of the face.
- Roof and floor
- Roof formed by the platysma and the SMAS; floor formed by the fascia covering the masseter.
- Boundaries
- Anterior by the masseteric ligaments, posterior by the parotid and inferior by the region of the mandibular border.
- Contents
- A gliding space, with no major vessels or nerves inside; branches of the facial nerve run beneath the floor.
- Relevance in HOF
- Helps explain jowl formation and the mobility of the lateral cheek with age.
The premasseter space is a gliding space located over the lower part of the masseter muscle, between the platysma and the SMAS, which form the roof, and the fascia that covers the masseter, which forms the floor. It is one of the facial spaces described in layered anatomy: areas of loose tissue, separated by ligaments, that let the face move over the fixed structures. In HOF, it helps explain why the lateral cheek gives way with age and how the jowl forms.
Where is it and what are its boundaries?
| Boundary | Structure |
|---|---|
| Roof (superficial) | Platysma and SMAS, with subcutaneous tissue and skin above |
| Floor (deep) | Masseteric fascia, over the masseter muscle |
| Anterior | Masseteric ligaments, at the anterior border of the masseter |
| Posterior | Region of the parotid gland |
| Inferior | Near the edge of the mandible, where the platysma attaches more firmly |
| Superior | Upper part of the masseter, more fixed, where the parotid duct and branches of the facial nerve pass |
Descriptions vary slightly between authors, but the pattern is the same as the layer of facial spaces: a mobile area bounded by retaining ligaments.
Why does it matter in HOF?
- Jowl formation: with aging, the roof of the space and the anterior boundary become looser. The tissues of the lateral cheek descend and gather in front, next to the mandibular ligament, which holds the skin at the point where the prejowl sulcus appears.
- Reading laxity: separating what is soft tissue descent from what is loss of bone or fat support changes the treatment plan. The full assessment is in lower face laxity: assessment.
- Neighboring space of the cheekbone: above it, the prezygomatic space plays a similar role over the zygomatic bone. The two explain a good part of the mobility of the midface and lower face.
- Toxin in the masseter: injecting the muscle crosses this area, and knowing the layers is part of procedure safety, described in botulinum toxin in the masseter.
How does it show up in the assessment?
- Pinching the lateral cheek: shows how much the tissue over the masseter shifts.
- Patient seated and lying down: the difference between positions reveals the weight of laxity.
- Jaw contour from the front and in profile: the jowl breaks the straight line between the angle and the chin.
- Masseter contraction: separates muscle volume from soft tissue volume.
Also called: premasseter space, space over the masseter.
Frequently asked questions
What is the premasseter space?
It is a gliding space between the platysma, above, and the fascia of the masseter muscle, below, in the lateral and lower part of the cheek. It allows the tissues to move during chewing and expression and becomes looser with aging.
Terms mentioned
Related reading
Aging face: where it starts and how to plan treatmentFacial aging involves bone, fat, muscle and skin, each at its own pace by area. Learn how to read the face and organize a stepwise plan.Aligning Expectations in Mature SkinWhat mature skin can and cannot expect from filler, toxin, biostimulators and threads, and how to run that conversation in a facial harmonization consultation.Aligning Expectations With a Patient After Prior Facial SurgeryWhat changes in the conversation when facial surgery has altered the anatomy: history, limits, risks, simulation and records before any injectable.Areas That Often Go Together in a Facial Harmonization PlanA map of affinities between Harmy's nine areas: which combinations appear together in a facial harmonization plan, why, and when to split them into stages.Assess the facial skeleton before injecting volumeHow to tell a bone deficit from a soft tissue deficit in a HOF treatment plan, what to look for in the facial skeleton, and when volume is not the answer.Asymmetric face: what is normal and what to treatHow much facial asymmetry is expected, how to measure it in the photo and in the consultation, and when the difference between sides deserves a plan.